Factors associated with non-compliance to the pre-analytical phase of the malaria thick blood smear in the Lemba Health Zone, Democratic Republic of Congo

Introduction: The medical laboratory is an important link in the process of patient care; it guides the practitioner to make a diagnosis or prognosis of diseases, especially to ensure therapeutic follow-up. Laboratory results contribute from 31% to 85% in the establishment of the diagnosis. The study determined the factors associated with non-compliance in the pre-analytical phase of the thick blood smear for malaria in the health facilities of the Lemba health zone. Methods: A cross-sectional study was conducted in 8 laboratories of the Lemba health zone. The statistical units were the health facilities, the analysis requesters, the request forms and the laboratory technicians. The chi-square test allowed us to determine the factors associated with the non-compliance of the pre-analytical phase of the thick drop. Results: The frequency of thick drop requests was 65% of the total number of analysis request forms issued, nearly six out of ten test vouchers were non-compliant, and more than six out of ten pre-treated samples were non-compliant. Three factors were associated with non-compliance in the pre-analytical phase of the thick drop, the nursing category (cOR=12.5; 95% CI: 5.61-28.00), lack of training of laboratory technicians on how to perform the thick drops ( (cOR=16.0; 95% CI: 1.60-159.31, lack of standard operating procedure (cOR=9.6; 95% CI: 4.72-19.59) Conclusion: As the thick drop is a reliable technique for the biological diagnosis of malaria, it is very important that its pre-analytical phase conforms to ISO 15189 standards, in order to guarantee the reliability of laboratory results and enable clinicians to guide their approach to the medical management of malaria patients.